Exploring Future Horizons in Osteoarthritis Relief: Unveiling the Potential of Slow-Acting Drugs and Innovative Medications

Abstract

Introduction: 
 The existing treatment options for osteoarthritis (OA) fall short of addressing the significant challenges this disease imposes on patients in today's society. It markedly diminishes the quality of life of those affected and is one of the leading causes of disability. While conventional pharmacological interventions such as non-steroidal anti-inflammatory drugs (NSAIDs) and opioids effectively address pain, they are not intended to halt disease progression and are associated with potential health risks. Symptomatic Slow-Acting Drugs for Osteoarthritis (SYSADOA) and innovative medications, rooted in our expanding understanding of OA pathogenesis, offer promising prospects for discovering improved treatment modalities.
 
 State of knowledge: 
 The evolving understanding of OA's etiology highlights the necessity for tailored treatments that consider distinct disease phenotypes. This review critically examines SYSADOA, specifically focusing on chondroitin sulfate, glucosamine, and avocado-soybean unsaponifiables, as agents designed to address the underlying pathology of OA. Chondroitin sulfate demonstrates potential disease-modifying effects, however with conflicting study results that underscore the extent of its efficacy. Glucosamine exhibits varying disease-modifying effects, with short-term trials demonstrating more promising outcomes in pain reduction. Avocado-soybean unsaponifiables show promise in alleviating knee OA pain, yet their impact on hip OA symptoms remains inconclusive. The review extends its scope to novel drugs with potential disease-modifying effects, exploring proteinase inhibitors, fibroblast growth factors, Wnt-signaling pathway inhibitors, senolytic agents, anti-nerve growth factor agents, and transforming growth factor-β.
 
 Conclusions: 
 Although preliminary studies indicate potential for certain novel agents, challenges and adverse effects necessitate further investigation through rigorous, high-quality research.